Department of Urology, Chang Gung Memorial Hospital at Linkou, 333, Taoyuan, Taiwan.
School of Medicine, Chang Gung University, 333, Taoyuan, Taiwan.
World J Urol. 2024 May 9;42(1):305. doi: 10.1007/s00345-024-04918-1.
Postoperative urinary retention (PUR) is a common complication after prostate enucleation, which leads to an increased length of hospital stay and decreased postoperative satisfaction. This study determined the predictive factors of postoperative urine retention within 1 month after prostate enucleation and investigated whether PUR influences surgical outcomes at the 2-week, 3-month, and 6-month follow-up time points.
Data were collected from the electronic medical records of 191 patients with benign prostatic obstruction (BPO) during October 2018 to September 2021. Of them, 180 patients who underwent thulium laser or plasma kinetic enucleation of the prostate (ThuLEP, PKEP) were separated into the PUR group (n = 24) and the non-PUR (NPUR) group (n = 156). Uroflowmetry and the International Prostate Symptom Score (IPSS) questionnaire were followed up at 2 weeks, 3 months, and 6 months postoperatively.
The PUR group had a significantly higher percentage of patients with type 2 diabetes mellitus (DM) than the NPUR group. Postoperatively, compared with the NPUR group, the PUR group had significantly less improvement in changes in the IPSS Quality of Life scores at 2 weeks, the total IPSS(International Prostate Symptom Score) at all follow-up times, the IPSS-S(IPSS storage subscores) at 2 weeks and 3 months, and the IPSS-V(IPSS voiding subscores) at all follow-up times. Predictive factors for PUR include lower preoperative maximum urinary flow (Qmax), lower preoperative total IPSS, and higher operation time.
Lower preoperative Qmax, lower IPSS scores, and longer operation time were risk factors for PUR. Furthermore, PUR could be a prognostic factor for prostatic enucleation surgical outcomes.
前列腺剜除术后尿潴留（PUR）是一种常见的并发症，会导致住院时间延长和术后满意度降低。本研究旨在确定前列腺剜除术后 1 个月内发生术后尿潴留的预测因素，并探讨 PUR 是否会影响术后 2 周、3 个月和 6 个月随访时的手术结果。
本研究收集了 2018 年 10 月至 2021 年 9 月期间 191 例良性前列腺梗阻（BPO）患者的电子病历资料。其中，180 例行钬激光或等离子前列腺剜除术（ThuLEP、PKEP）的患者分为 PUR 组（n=24）和 NPUR 组（n=156）。术后 2 周、3 个月和 6 个月分别进行尿流率和国际前列腺症状评分（IPSS）问卷随访。
PUR 组中 2 型糖尿病（DM）患者的比例明显高于 NPUR 组。与 NPUR 组相比，PUR 组在术后 2 周时 IPSS 生活质量评分的变化、所有随访时间的总 IPSS（国际前列腺症状评分）、2 周和 3 个月时的 IPSS-S（IPSS 存储亚评分）以及所有随访时间的 IPSS-V（IPSS 排尿亚评分）方面的改善明显较少。PUR 的预测因素包括术前最大尿流率（Qmax）较低、术前总 IPSS 较高和手术时间较长。
术前 Qmax 较低、IPSS 评分较低和手术时间较长是 PUR 的危险因素。此外，PUR 可能是前列腺剜除术手术结果的预后因素。
